MEDICARE: RELIABLE PERSONAL CARE SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	13-012999-1	IN
2	253Z00000X	In Home Supportive Care Agency	11-012074-1	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12-012074-1	OTHER	IN	INDIANA STATE DEPARTMENT OF HEALTH
2	12-012999-1	OTHER	IN	INDIANA STATE DEPARTMENT OF HEALTH
3	15D2044947	OTHER	IN	CLIA
4	200930770	OTHER	IN	LPI

General Provider Information

NPI Number	:	1073897070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RELIABLE PERSONAL CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	2141 N FRANKLIN RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-2435
Country	:	US
Telephone Number	:	317-375-8530
Fax Number	:	317-894-9887

Provider Business Practice Location Address
First Line	:	2141 N FRANKLIN RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-2435
Country	:	US
Telephone Number	:	317-375-8530
Fax Number	:	317-894-9887

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ERRON CLAYTON
Credential	:	MBA
Telephone Number	:	317-375-8530

Provider Enumeration Date	:	10/09/2011
Last Update Date	:	04/29/2015

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Directions to “RELIABLE PERSONAL CARE SERVICES, LLC ” Practice Location

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